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Re: 2 yrs and half & counting - breath test +ve stool - ve - 3 courses failed

Posted: Tue Aug 27, 2019 5:33 pm
by Helico_expert
I dont like Tetracycline and Amoxicillin combination. The outcome is very conflicting. Of course, your doctor would have more understanding of this combination in your region.

my opinion would be
Rabeprazole 20mg TID
Bismuth 240mg QID
Amoxicillin 1000mg TID
Furazolidone 100mg TID

These are two of those papers that showed PBAT has a poor treatment success rate.
https://www.dovepress.com/efficacy-of-a ... rticle-IDR

https://onlinelibrary.wiley.com/doi/ful ... /apt.12089
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Re: 2 yrs and half & counting - breath test +ve stool - ve - 3 courses failed

Posted: Thu Aug 29, 2019 9:15 am
by glglak
my region is Sydney, Australia, I am originally from Egypt though, so would you recommend taking a second opinion?
what about the side effects of both treatments, the one you mentioned and the one prescribed? If I decided to go on with doctor recommendation, would it have a chance to increase the bacteria resistence "for tetrcycline"?

Re: 2 yrs and half & counting - breath test +ve stool - ve - 3 courses failed

Posted: Thu Aug 29, 2019 3:24 pm
by Helico_expert
H. pylori almost become resistant to tetracycline. But the failure of PBAT is probably the counter interaction of amoxicillin and tetracycline.

I would say Furazolidone has more side effect. But you may not feel it. Not everyone will experience side effects from these antibiotics.

I am bias towards the use of PBAF or PBTF. I am not too keen on PBAT.

Re: 2 yrs and half & counting - breath test +ve stool - ve - 3 courses failed

Posted: Tue Sep 10, 2019 11:47 am
by glglak
Hello,

I mesaage my specialist with all information you sent me and the below is his reply, shall I have a second opinion?

Dear Karim,

Thank you for your email. We have not checked sensitivity to furazolidone as it is not part of our standard sensitivity panel. The choice of amoxycillin + tetracycline was based on the proven sensitivities of your H.pylori organism. So this is not an empiric third line therapy but a regimen based on tested sensitivities. I think that you should have the initially recommended combination and I am happy to send the prescriptions out to you.

Kind Regards,

Stephen Tattersall

Re: 2 yrs and half & counting - breath test +ve stool - ve - 3 courses failed

Posted: Tue Sep 10, 2019 10:24 pm
by Helico_expert
Your doctor seems confident with the treatment and you should follow his instruction. Anyway, the recommendation here can always be the backup plan if PBAT failed.